بــسم
الـله الـرحمن
الـرحيم
مـوقع الدكتور محمد علي البار Dr. Moahammed Ali Albar نحو طب إسـلامي هادف على
الإنـترنــت Our way to Islamic Medicine |
طـــب
المــرأة
اختلاف الذكر
عن الأنثى في تركيبها
الجسدي
العودة إلى
الصفحة الرئيسة الدكتور
محمد علي البار
أثبتت
الدراسات الطبية
المتعددة أن كيان
المرأة النفسي
والجسدي قد خلقه
الله تعالى على
هيئة تخالف تكوين
الرجل ، وقد بني
جسم المرأة ليتلاءم
مع وظيفة الأمومة
ملاءمة كاملة ،
كما أن نفسيتها
قد هيئت لتكون
ربة أسرة وسيدة
البيت ، وقد كان
لخروج المرأة إلى
العمل وتركها بيتها
نتائج فادحة في
كل مجال .. ويقول
تقرير هيئة الصحة
العالمية الذي
نشر في العام الماضي
أن كل طفل مولود
يحتاج إلى رعاية
أمه المتواصلة
لمدة ثلاث سنوات
على الأقل . وإن فقدان
هذه الرعاية يؤدي
إلى اختلال الشخصية
لدى الطفل كما
يؤدي إلى انتشار
جرائم العنف الذي
انتشر بصورة مريعة
في المجتمعات الغربية
. وقد أثبتت الدراسات
الطبية والنفسية
أن المحاضن وروضات
الأطفال لا تستطيع
القيام بدور الأم
في التربية ولا
في إعطاء الطفل
الحنان الدافق
الذي تغذيه به
.
الاختلاف على
مستوى النطفة
:
وإذا
سرنا في سلم الفروق
، وارتفعنا إلى
مستوى الخلايا
التناسلية فسنجد
الفرق شاسعا والبون
هائلا بين الحيوانات
المنوية وبين البويضة
.
تفرز
الخصية مئات الملايين
من الحيوانات المنوية
في كل قذفة مني
بينما يفرز المبيض
بويضة واحدة في
الشهر . ونظرة فاحصة
لخصائص الحيوان
المنوي الذي يقاس
بالميكرون تجعلنا
نوقن بأنه يجسد
خصائص الرجولة
. بينما نرى البويضة
تجسد خصائص الأنوثة
فالحيوان المنوي
له رأس مدبب ، وعليه
قلنسوة مصفحة وله
ذيل طويل وهو سريع
الحركة قوي الشكيمة
لا يقر له قرار
حتى يصل إلى هدفه
أو يموت . بينما
البويضة كبيرة
الحجم ( 0.5 مليمتر
) وتعتبر أكبر خلية
في جسم الإنسان
الذي يحتوي على
ستين مليون مليون
خلية . وهي هادئة
ساكنة تسير بدلال
وتتهادى باختيال
وعليها تاج مشع
يدعو الراغبين
إليها ، وهي في
مكانها لا تبرحه
ولا تفارقه ، فإن
أتاها زوجها وإلا
ماتت في مكانها
ثم قذفها الرحم
مع دم الطمث .
وإذا
دققنا النظر في
قطرة صغيرة من
مني الرجل تحت
المجهر لهالنا
ما نرى .. مئات الملايين
من الحيوانات المنوية
تمخر عباب بحر
المني المتلاطم
وهي تضرب بأذيالها
لتجري في طريقها
الشاق الطويل الوعر
المحفوف بالمخاطر
حتى تصل إلى البويضة
، وفي أثناء هذه
الرحلة الشاقة
الهادرة تموت ملايين
الحيوانات المنوية
ولا يصل إلى البويضة
إلا بضع مئات .
وهناك
على ذلك الجدار
تقف هذه الحيوانات
تنتظر أن يؤذن
لها بالدخول وتتحرك
يد القدرة الإلهية
ليلقح تلك الدرة
المكنونة .. ويلج
الحيوان المنوي
سريعا إلى هذه
الكوة والفرجة
ليقف وجها لوجه
أمام البويضة
.. وهناك يفضي لها
بمكنون سره ويعطيها
أسرار الوراثة
وتعطيه ، ويتحدان
ليكونا النطفة
الأمشاج التي يخلق
الله سبحانه وتعالى
منها الإنسان كاملا
...
وظائف المرأة
الفيسيولوجية
تعوقها عن العمل
خارج المنزل
العودة إلى
الصفحة الرئيسة الدكتور
محمد علي البار
وإذا
نظرنا فقط إلى
ما يعتري المرأة
في الحيض والحمل
والولادة ، لعرفنا
أن خروجها إلى
مجال العمل إنما
هو تعطيل للعمل
ذاته .. كما أنه مصادم
لفطرتها وتكوينها
البيولوجي الذي
لا مندوحة عنه
..
أ
) المـحيض :
إن
أنثى الإنسان
.. والثدييات العليا
مثل القردة والشمبانـزي
هي التي تحيض ولها
دورة رحمية كاملة
.. أما بقية الحيوانات
فلا تحيض إناثها
رغم ما يشاع عن
حيض الأرنب والضبع
والخفاش .. فهذه
جميعا لا تحيض
وإن كانت تنـزل
دوما من أرحامها
عند اهتياجها الجنسي
الشديد
وللحيوانات
جميعها فترة محدودة
للنشاط الجنسي
وعادة ما يكون
في فصل الربيع
بينما النشاط الجنسي
للإنسان متصل على
مدار العام .. ولا
تفرز الإناث من
هذه الحيوانات
بويضاتها إلا في
فترة محدودة من
العام ، بينما
تفرز المرأة بويضة
مرة في كل شهر منذ
البلوغ إلى سن
اليأس. أي خلال
ما يزيد عن ثلاثين
عاما كاملة .. وهي
طوال هذه المدة
معرضة للحيض في
كل شهر إذا وقع
الحمل وتتعرض المرأة
أثناء الحيض لآلام
ومعاناة نلخصها
كما يلي :
1. تصاب
بعض النساء بالصداع
النصفي قرب بداية
الحيض .. وتكون الآلام
مبرحة وتصحبها
زغللة في الرؤية
وقيء
2. تصاب
أكثر النساء بآلام
وأوجاع في أسفل
الظهر وأسفل البطن
.. وتكون آلام بعض
النساء فوق الاحتمال
مما يستعدي استدعاء
الطبيب واستعمال
الأدوية المسكنة
للألم .
3. تصاب
الغدد الصماء بالتغير
أثناء الحيض فتقل
إفرازاتها الحيوية
الهامة للجسم إلى
أدنى مستوى لها
أثناء الحيض .
ب
) آلام الـولادة
:
إن
آلام الطلق تفوق
أي ألم آخر .. ومع
هذا فلا تكاد المرأة
تنتهي من ولادة
حتى تستعد لولادة
أخرى .. ولا يكاد
الطفل يخرج إلى
الدنيا ويلامس
جسمه جسمها حتى
يفتر ثغرها عن
ابتسامة متعبة
وهي تعطيه أول
رضعة من ثديها
. وفي الماضي كانت
الولادة عملية
شديدة الخطورة
وتنتهي كثير من
حالاتها بوفاة
الأم أو وفاة الجنين
أو وفاتهما معا
..
كما
كانت حمى النفاس
منتشرة بين الوالدات
.. والحمد لله فقد
أمكن في العصور
الحديثة خفض مضاعفات
الولادة على الأم
والجنين ولكن الطب
لم يتمكن ولن يتمكن
من إزالة جميع
مخاطر الولادة
.. ولا تزال مجموعة
من النساء يلدن
بالعملية القيصرية
.. ومجموعة أخرى
يلدن بالجفت .. كما
أن مجموعة قليلة
تفقد حياتها أثناء
الولادة أو بسبب
حمى النفاس أو
تمزق الرحم .. أما
الأمراض المزمنة
الناتجة عن الحمل
والولادة فلا تزال
رغم التقدم الطبي
الهائل ليست بالقليلة
. وأهمها أمراض
الكلى وضغط الدم
وأمراض القلب وأمراض
الجهاز التناسلي
وأمراض الكبد
.. كما أن الأمراض
النفسية وحالات
الكآبة تكثر أثناء
الحمل وفي فترة
النفاس ..
العودة إلى
الصفحة الرئيسة الدكتور
محمد علي البار
A clamor of opposing opinions arises
from different camps of religious groups, secular humanists, liberals and
feminists regarding induced abortion, creating divisions, dichotomies and even
conflict that end in many acts of violence and loss of life. Indeed abortion is the most controversial
area of family planning, and it is the last to achieve clinical understanding
and social acceptance. However it is
the most important method used by those calling for fertility regulation and
family planning(1)
Definition
of Abortion: It is
astonishing to find differences in defining abortion by different laws,
countries and medical practices at different times. Sir Stanley Clayton and John Newton in their booklet: A Pocket
Obstetrics (2) define abortion as the expulsion of the conceptus
before the 28th week of pregnancy; a view that is still held by the
British law up to this moment (3).
Ralph Benson in “handbook of obstetrics and Gynecology” (4)
defines abortion as “the termination of pregnancy before the fetus is
viable. Technically, viability is
reached at 23-24 weeks, when the fetus weighs slightly more than 600
grams”. The U.S.A law is variable from
state to state. The law allows abortion
on demand in the first trimester of pregnancy, with more restrictions in the
second trimester, limiting it to medically indicated cases. WHO (world Health Organization) defined
abortion as “the expulsion or extraction of a fetus or embryo weighing 500
grams or less from its mother ” (5).
The
medical opinion nowadays define abortion as the expulsion of conceptus prior to
viability which is defined as 20 weeks of pregnancy or a fetus weighing 500
gram or more. Recently some states
lowered the weight of viability to 300 gram (5).
Terms
as miscarriage are usually used by the public to denote spontaneous abortion,
while the term abortion denotes induced abortion whether legalized or not (5).
The
Encyclopedia Britannica of 1982 defined abortion as the termination of
pregnancy before viability which was defined to be 1000 gram fetus by weight or
more than 20 weeks of pregnancy (3).
Incidence
of Induced Abortion
Dr.
Guilleboud in his book “The pill” estimates the incidence of induced abortion
in the early eighties of the twentieth century to be 40 million annually; half
of them being performed legally while the other half performed as
surreptitiously, resulting in the death of about 200,000 women and infliction
of hundreds of thousands annually with many serious complications including
pelvic inflammatory disease, recurrent abortions and sterility (6). Hawkins and Elder claim in their book “Human
Fertility control”, that induced abortion is the most effective method used for
curbing increase of population and family planning, resulting in major decrease
of growth of different populations (7). The time magazine of August 6, 1984 puts the number of induced
abortions globally at 50 million annually (8). Induced abortion in Japan has stabilized at
3 million annually, legally and illegally, which resulted in the decrease of
annual birth rate to 13.5 per 1000(1, 10). The pill is still not available in Japan.
The
incidence of induced abortion is very high both in Russia, China and the
previous East European block, mainly due to lack of the pill, and abortion
being used as a means of birth control.
In Belarus there are 200 abortions for each 100 live births i.e. ⅔
of all pregnancies.(11).
Similarly
in Latin American countries, which are all Catholic and where contraceptive
methods are antagonized by the church (except the safe period), the incidence
of induced criminal abortion is estimated at 3 millions annually. In the Iberian Peninsula (Spain and
Portugal), another Catholic area, where contraceptive methods and abortion are
both antagonized by the church, the incidence of criminal abortion is estimated
at 1 million annually, the highest in Western Europe and resulting in the
annual death of 3500 women. In Manila
(Philippines) it is estimated that 100,000 woman are aborted illegally annually,
a figure similar to the abortions conducted in Britain (the population of
Manila is 5 million, while the population of Britain is 55 million) (1,
12).
The
figures of induced abortion have stabilized in the USA since abortion was
legalized in 1973, at 1,5 to 1,6 million annually. More than 60% of all the induced abortions in USA, Canada and
Europe are done for young unmarried girls under the age of 20. About one quarter of all performed abortions
are carried out for teenagers under the age of 17. The prestigious medical journal Pediatrics (supplement 1985) on
“Sex, Drugs, Rock ‘N’ Roll, and Understanding Teenagers Behavior”(13) mentioned
that 1,2 million unmarried teenage girls between 12 and 17 years of age get
pregnant annually in USA. 49% of them
continue their pregnancy until delivery and are dubbed “Virgin mothers”, while
13% have spontaneous abortions and stillbirths, while the rest, 400,000 get
aborted. The Time magazine claims that
one third of all high school girls get pregnant annually (unmarried) which ends
in abortion in half of them, while the rest continue until delivery (14).
By
1982, 80% of all pregnancies for girls under 20 in Britain were out of wedlock,
and about half of them procured induced abortion (15).
It
is evident that promiscuity and sex revolution constitute the major cause of
unwanted pregnancy and hence induced abortion, whether legally performed or
surreptitiously, the latter being fraught with serious complications and even
death. In the USA, despite the availability
of contraceptive methods for young girls in schools, the rate pregnancy is very
high indeed. The Time magazine
(December 9, 1985) (14) gave the following figures: 30,000
pregnancies for those under 15, and by the age of 17 the figure increases to
1,200,000 (also confirmed by the medical journal pediatrics) (13). By the age of 20 there are 2 million
pregnancies outside wedlock, which result in abortion of about a million of
them annually. All the studies show
that both the pregnancies and abortions are at a much higher level for Afro
American’s than for Caucasian origin,(1, 12) the rate being 2.5 to
1. Late in the nineties of the
twentieth century, the occurrence of abortion for teenage girls has decreased
in USA, as girls became more adept at using contraceptive methods(16,17) A new method of female infanticide is
spreading in many countries, especially in China and India after the spread of
ultrasonography. If the conceptus
proves to be a female by ultrasound, then the parents resort to abortion, which
unfortunately is done in the second trimester ending in many complications,
especially if it is done illegally (18).
The
medical indications for performing abortion are broadened to include not only
the physical ailments, but also alleged psychological disturbances that will result
from continuation of pregnancy.
Similarly if continuation of pregnancy is going somehow to affect any
member of the family, then abortion is the solution of the expected family
problems. (The British Law of 1967
regarding Abortion). Another new type
of indication is what is called “reduction of pregnancy” where the lady
suffering from fertility gets pregnant with multiple fetuses either through
hormonal treatment alone, or by in vitro fertilization, where the treating
physician reintroduces more than three fertilized ova (pre embryos) into the
uterus. Such practice was deprecated by
Islamic Jurists in their meeting in Kuwait in 1987(19) and Amman
1986 (Jordan)(20). Later-on
gynecologists all around the world passed a regulation to limit reintroduction
of fertilized ova to two or maximum three in each cycle in the management of
fertility by in Vitro fertilization
(IVF) methods.
Historical
Aspect of Legality of Induced Abortion:
Respect
for Human life from moment of conception:
The
medical profession since antiquity stood against inducing abortion. Imhotep of Egypt (3000 B.C, deitified as the
god of medicine) constructed an oath to be taken by all Practicing Physicians,
which prohibited the physician from prescribing an abortificient drug or pessary. Similarly the well known Hippocratic oath
entail the solemn pledge by the doctor not to procure abortion by drugs,
pessaries or any other means(21,.22). The Declaration of Geneva of 1968, was amended in Sydney,
reiterated the Hippocratic oath and pledged “I will maintain the utmost respect
for human life from the time of conception” (23). However the Declaration of Oslo, while
retaining this moral principal recognized the different opposing opinions on
the question of abortion: “Diversity of this situation results from diversity
of attitudes towards the life of the unborn child. This is a matter of individual conviction and conscience” (24).
This
profound change in attitude came as a result of cumulative change in the fabric
of many societies, where mores and life styles have completely changed.
It
is interesting to note that old civilizations, though prohibited and even
punished harshly those who commit abortion, were lax at some stage of their
development and condoned clandestine acts of abortion. Potts and Diggory in their Textbook of
contraceptive practice emphasized that abortion was practiced in Middle Kingdom
of Egypt (2133 – 1786 BC), and the excavations at Pompeii revealed vaginal
speculum suitable for performance of abortion(1). The Roman Poet Ovid lamented “There are few
women nowadays who bear all the children they conceive”(1). . It
seems equally true to the majority of women in many societies today, which have
legalized abortion on demand, or on tenous social or psychological causes.
The
Bible considered induced abortion as a crime but not as a murder, the
punishment being decided by the husband of the wife aborted in the form of
compensation. The judge can also punish
the perpetrator by strapping or imprisonment (1).
The
Catholic church was more stringent, and in the 7th century, passed a
canon punishing the perpetrator inducing abortion by capital punishment viz
murder (25).
England
passed a law in 1524, Germany in 1531, France in 1562 and Russia in 1649, which
punished the participants of the crime of abortion by death penalty (25).
With
the advent of the industrial revolution and social upheavals in the 18th
and 19th centuries, the European countries gradually revoked the
previous harsh laws and replaced them with less drastic penalties e.g.
imprisonment, fine and abrogation of medical practice license.
By
1929, the law in Britain allowed abortion if continuation of pregnancy was
expected to endanger the health of the expectant mother. The previous law allowed abortion only if
continuation of pregnancy endangered her life and not her health (1, 3).
From
1929 to 1967, induced abortion without a clear medical indication was
considered a criminal act and was penalized by imprisonment, fine and cancellation
of the medical practice license. The
1967 amendment issued by the British Parliament authorized the physicians to
abort a pregnant lady if:
(a) The threat to
her life through continued pregnancy is expected.
(b) Continued pregnancy posed a threat to her
physical or psychological health, or the health of children of the family
(whether her own children, her husband’s children or adopted children).
(c) The
likelihood presence of congenital anomalies in the fetus.
The operation
of abortion should be performed in an institution recognized by The Ministry of
Health, but it did not require a specialist to perform it (1, 21 ).
The first
country in the world to legalize abortion on demand was communist Russia, which
passed a law on 18th November 1920, “Permitting abortion to be
performed freely without charge in Soviet hospitals” (1). This resulted in decline of the family and
the population. Stalin saw the dangers
clearly and hence passed a new law in 1935, which restricted abortion to
medically, indicated reasons. The
Pravda applauded the law and wrote: “our Soviet women have been given the bliss
of motherhood. We must safeguard our
family”. However in 1955, the law of
1920 regarding abortion was reinstated (1, 25). The Satellite Eastern European countries soon followed suit, with
minor change here and there. Several
Scandinavian countries liberalized abortion laws since the thirties of the
twentieth centuries. Iceland in 1935,
Sweden and Denmark in 1938. Japan
allowed abortion on demand and as a means of contraception in 1948, and China
followed suit during the cultural revolution of the 1960s. Haiti and G. Britain passed their laws in
1967, India in 1971 and USA in 1973. By
1980 over 70% of the world’s population lived in countries where abortion was allowed
on demand or with minor restrictions.
Countries allowing Abortion on demand: Russia, China, Japan, the Scandinavian
countries, Eastern Europe, Vietnam, North Korea, U.S.A and Tunisia (the only
Muslim country) (25).
Countries allowing abortion with some restrictions: G. Britain,
Canada, India, France, Germany, Holland, Italy, Switzerland, Turkey and South
Africa.
Countries allowing abortion for strict medical reasons
only: Catholic countries e.g. Latin America, Ireland, Spain, Portugal, Malta,
Belgium, Philippines and all Muslim countries except Tunisia and Turkey. The Zaidi School (Yemen) of jurisprudence is
very lenient and allows abortion in the first 120 days of pregnancy (computed
from start of conception and not LMP) for both medical and social reasons (25).
It is quite
unfortunate to find many societies using induced abortion as a means of birth
control instead of using contraception.
Many gynecologists, policy makers, Planned Parenthood world population
and organizations related to United Nations call for using induced abortion as
a means of birth control, along with whatever available method including
sterilization of both males and females.
Encyclopedia Britannica mentioned the contemporary views and means of
birth control including strict government controls over population numbers
using compulsory sterilization to millions of the population as exemplified by
Mao Tse Tong (China) policy of sterilization, where 40 million were forcibly
sterilized, and by Indira Ghandi (India) policy where 24 million were compelled
to perform sterilization (3, 25).
Millions were also forced to abort, as the law in China allowed the
couple to have only one child (3).
Potts and Diggory claim in their “Textbook of
contraceptive practice” that “both contraception and abortion are essential for
controlling fertility. A society cannot
meet its fertility goals purely by the use of contraception. Therefore the combination of reversible
methods of contraception (and sterilization), and induced abortion will remain
necessary elements in fertility control.
Throughout history, and with increasing force over the past 100 years,
societies have used combination of contraception and abortion to control their
fertility. The moral and political
attributions of abortion services outweigh such factors as proven mortality
rates or the evidence of cost benefit studies.
Abortion will occur in law fertility societies, and are likely to be
most common in those in which birth rate is falling in response to socioeconomic
pressures” (1).
The previous paragraph quoted contains many
contradictory and illogical statements whereby abortion is used despite its
apparent dangers to health and life of expectant mothers, and used in low
fertility societies, which are supposed to increase the fertility by
prohibiting abortion and encouraging the birth of as many children as possible.
U.S.A
and European societies encourage third world countries to curb its fertility
and population increase even by resorting to methods unacceptable in their own
countries. They encourage governments
of third world to implement laws and measures to enforce the policy of birth
control, even if it involves compulsory sterilization, the use of unsafe
contraceptives or even forced abortion (1, 3, 25).
The
medical reasons for the so-called therapeutic abortion constitute a very small
portion of the number of abortions carried globally for social reasons. Potts and Diggory claim, “few abortions are
carried out because continuation of pregnancy threatens the woman’s life, and a
small proportion because of congenital anomalies of the fetus” (1). If a woman wishes to carry her pregnancy to
term and delivery, almost all obstetricians will try their best to fulfill her
desire, despite the fact that she may be suffering from a disease considered
otherwise as indication of abortion e.g. advance renal, hepatic, cardiac, or
poorly controlled diabetes, or hypertension, or taking immmosupressive drugs,
or suffering from blood dyscriasis.
Hawkins
and Elders in their book “Human Fertility control” emphasize that “countries
with a population problem have found it politically expedient, at least
tacitly, to support increased facilities for abortion. The public at large are aware that abortion
is either wrong or at least a medically and psychologically unsatisfactory
solution to social problems. The church
is faced with the difficulty that it cannot enforce its views without losing
its adherents… Few doctors are happy with those aspects of society which
produce the need for abortions; fewer still are satisfied with an environment
which generates defects in motivation to employ effective contraceptive
measures” (7).
The
majority of medical practitioners and gynecologists agree that since criminal
abortion is fraught with serious complications including loss of life, then for
pragmatic reasons, if abortion is to be carried out, then it should be done by
a licensed professional in a safe environment.
The complications of such a procedure are much reduced and the mortality
of the first trimester abortion is very low indeed, especially after the
introduction of anti progesterone agent e.g. RU 486 or mifepristone and
misoprostol which acts successfully (90%) if given to women less than 9 weeks
pregnancy (computed form LMP) 26.
The morality rate of illegal abortion is around 50 per 100,000, while
legal abortion in the first trimester mortality is around one to two per
100,000. In the second trimester the
mortality rate reaches 40 per 100,000 (1, 5). It is claimed that globally 200,000 women
die annually due to illegal abortion (6).
Abortion
should not be used as a means of birth control. The social causes leading to unwanted pregnancy should be dealt
with accordingly, and if need arises temporary means of contraception should be
available to couples. Abortion should
be limited strictly to medically indicated causes, which constitute a small
proportion of abortions carried in demand and for social reasons.
Religious
Aspects of Abortion
Islam,
Christianity and Judaism look to procreation as an integral part of
marriage. God said to both Adam and Eve
in the book of Genesis “Be fruitful and increase in numbers, fill the earth and
subdue it” (27).
In
Islam, procreation is not only an integral part of matrimony; it is an act of
worship. Even the sexual act with a
wife is considered as an act of charity as proclaimed by the Prophet Mohammed
PBUH (28). The Holy Quran
proclaims: “O’ mankind be conscious of your Sustainer, who has created you out
of one living entity, and out of it created its mate, and of the two spread
abroad a multitude of men and women” (29).
“And
God has given you mates of your kind, and has given through your mates children
and grand children” (30).
The Prophet Mohammed said to all Muslims: “Get married, beget and
multiply because I will be proud of you among nations” (26). He also said: “marry the kind and fertile,
for I will be proud of your numbers among other nations” (32).
Though
Islamic teachings encouraged procreation within matrimonial bondage, it did not
altogether prevent the temporary means of contraception. The Prophet himself (PBUH) allowed his
companions to practice aazel i.e. coitus interruptus (Onanism) (33,35).
His
teachings stand in stark contrast to what is mentioned in the Old Testament,
the Book of Genesis. Onan, the son of
Judah and the grandson of Jacob, spilled his seed on the ground to keep from
producing offspring for his deceased brother when he married his widow Tamar
(The Jewish teachings gave the offspring to the deceased husband if he had no
children, and the lineage will not be given to the actual father). God was furious and caused the death of
Onan (36).
The
Catholic church holds the most conservative and stringent view point against
any means of contraception except abstinence and abstention during and before
ovulation i.e. using the safe period.
Similarly it holds the most conservative point of view against abortion
at any stage of pregnancy as human life is considered to start from
fertilization. The fertilized ovum is
given the status of a human being, and hence killing it by any means is
tantamount to the crime of manslaughter.
In
Islam, temporary means of contraception are allowed provided it causes no harm,
and should be done by the mutual agreement between consorts (37). Sterilization will not be allowed except for
clear medical indications, where pregnancy is going to endanger seriously the
health or life of the expectant mother (37).
Similarly
abortion will only be allowed if continuation of pregnancy is going to endanger
the life or health of the expectant mother; or if there is proven serious
congenital anomaly in the embryo or fetus.
The performance of abortion should be done prior to 120 days from the
start of conception, which is considered according to the Hadith (sayings) of
the Prophet to be the time of ensoulment.
However, if the life of the expectant mother is endangered, and not only
her health, abortion or pre term delivery can be performed at any time of
pregnancy to save her life. The
decision of abortion should be agreed upon by three specialist physicians with
clear medical indication (38-40).
This was the Fatwa
(Decision) of the Islamic jurists council of Makkah Al-Mukaramah (Islamic World
League) held in Makkah from 10 to 17th February 1990. However the decision was passed by the
majority of votes, with abstention of the president late Shaikh Abdulaziz
BinBaz and Shaikh Bakr Abu Zaid (40).
Many
Islamic jurists are more stringent and would allow abortion in the first 40
days of conception (computed from fertilization and not LMP). In fact this was the official Fatwa in Saudi
Arabia until the Fatwa of Islamic jurists council of Makkah extended it to 120
days from start of conception in 1990.
More
conservative jurists like the Maliki School and Imam Al Gazali (from Shafii
School of Jurisprudence) will not allow abortion at any time of pregnancy
except to save the life of the expectant mother (41,42).
Nevertheless
there are some jurists who will allow abortion for social reasons e.g. rape or
where continuation of pregnancy will affect a nursing child and where a wet
nurse is not available or the father is too poor to afford a wet nurse (25,
41). Prominent among those
allowing abortion are Zaidi School of jurisprudence who will allow abortion for
social and minor medical reasons in the first 120 days of conception (25). Some jurists of the Hanafi, Hanbali and
Shafii School will follow suit with minor restrictions (25). However the majority of Islamic jurists
throughout history will not allow abortion except for strong medical
reasons. This arises from the respect
of Islam to life. There are a lot of
Quaranic ayas and Hadiths regarding the sanctity of life. “We decreed upon the children of Israel that
who so ever kills a soul for other than manslaughter or corruption in the land;
it shall be as if he killed all mankind, and whosoever saves the life of one,
it shall be as if he saved the life of mankind (43).
The
Quran deplored killing children for want or fear of want “Kill not you children
on a plea of want. We provide
sustenance for you and for them. Come
not near not near to shameful deeds whether open or secret. Take not life, which God has made sacred
except by ways of justice and law. Thus
does He command you that may learn wisdom” (44).
“Kill
not your children for fear of want. We
shall provide sustenance for them as well as for you. Verily the killing of them is a great sin” (45).
Ibn Massoud (a companion of the
Prophet) asked the Prophet: What is the gravest sin? The Prophet (PBUH)
answered: “That you associate partners with God who created you” Ibn Massoud
asked: What is next to this? And the Prophet answered “That you kill your
offspring for fear of them sharing your food with you” (46, 47)
(Bokhari & Muslim).
Though
Muslims at large consider the embryo from its earliest stages to be living they
do not give it the status of a full human life except after ensoulment. Ibn Al Qaiyim in his book Attibian Fi Aksam
Al Quran brings this question by asking Does the embryo before ensoulment
(breathing of the spirit into it) has a life? He answered yes, the embryo has
the life of growth and nourishment like a growing plant, but once the spirit is
breathed in he acquires perception and volition.” (48).
Similarly Ibn Hajar Al Asqalani discussing
which organ forms first in the embryo in his volummous Fateh ul Bari says, “the
liver is the first organ formed as it is the site of nutrition and growth. Voluntary movement and perception are
acquired only after ensoulment” (49).
Ensoulment
only occurs after many stages at which the embryo passes. The Holy Quran says: “We created man from
the quintessence of mud. Thereafter, we
cause him to remain as a drop of fluid (Nutfa) in a firm lodging (the
womb). Thereafter, we fashion the Nutfa
into something that clings (Alakah), which we fashioned into a chewed lump
(Modgha). The chewed like lump is
fashioned into bones, which are then covered with flesh. Then we nurse him into another act of
creation. Blessed is God, the best of
artisans” (50).
All
the ulema and commentators of the Holy Quran agree that the other act of
creation mentioned above is the time of ensoulment where the spirit is inspired
into the body of the fetus.
The
Hadith (sayings) of the Prophet narrated by Ibn Massoud “The creation of each
one of you is collected in the womb of his mother in forty days. And something that clings (Alakah) he
becomes for forty days, and then he becomes Modgha (a chewed lump) for forty
days. The angel is sent to him and the
angel writes four things: his provision (sustenance), his life span, his deeds
and whether he will be wretched or blessed.
Then the spirit is breathed into him”.(51,52) (AlBokhari,
Muslim, others).
This
simply means that ensoulment occurs at 120 days computed from the beginning of
conception. However there is another
Hadith narrated by Huzaifa Ibn Aseed which made some ulema (jurists of Islamic
nation) decide that forty days computed from the beginning of conception is the
line of demarcation and the beginning of human life.
“When
the Nutfa enters the womb and stays there for 42 nights, God sends an angel to
give it a form and create its hearing, sight, skin, bone and flesh. Then the angel asks, “O God is it a boy or a
girl ? and God determines whatever He decides.
He then asks what is his livelihood and God determines (Muslim) (52).
It
is interesting to note that organogenesis (i.e. formation of organs in the
embryo) takes place between the 4th and 8th week of
conception (computed from
fertilization) and reaches its zenith at 42 days. The embryo has unidentified gonad until that period after which
the gonad differentiates into either a testes or an ovary. Similarly the brain stem forms and starts to
function in an embryo of 42 days.
However the higher functions of the brain are still forming and the
cerebral cortex does not have synapses with the lower centers except at the
beginning of the 20th week computed from last menstrual period,
which is equivalent to 120 days computed from fertilization (viz beginning of
conception). Dr. Koren J. presented a paper in the conference on
Ethics of organ transplantation in Ottawa, Canada August 20 – 24, 1989, in
which he proved with dissection of many aborted fetuses that synapses between
the higher centers of the cerebrum and the lower centers does not start to work
except in the beginning of the 20th
week of pregnancy computed from the LMP which is equivalent to 120 days
computed from moment of conception (fertilization) (53).
It
is evident that both sayings of the Prophet Mohammad (PBUH) speak of different
times of development of the CNS of the fetus, the Hadith of 42 days refers to
the development and functioning of the brain stem, while the Hadith of 120 days
speaks about the higher centers and its control over the lower ones in the CNS.
There
are a lot of Hadiths (sayings of the Prophet Mohammed PBUH), which
assign to the conceptus an important status that gradually
increases, with the time of pregnancy.
If a lady commits a crime punished by the death penalty, then the
fulfillment of the penalty is postponed until delivery and nursing of the baby
for two years, or if a wet nurse is available for a much shorter period. This applies even if the pregnancy is
illegitimate (21,25,41,54).
The
fetus has the right of lineage of his father, and if his father dies while he
is in utero, his share of the inheritance will be kept for him/her until
delivery.
Killing the fetus intentionally or
unintentionally is penalized by paying
1/20 of the diyha (blood
fine), which is equivalent to 500 golden dinars. There is another penalty to be decided by the magistrate for
intentionally induced abortion (25,41,54).
Sheikh
Mohmoud Shaltout (grand Imam of Al Azhar in the forties and early fifties of
the 20th century) wrote: “ Old scholars are agreed that after
quickening takes place (120 days of conception), abortion is prohibited to all
Muslims, for it is a crime perpetrated against a living being. Therefore blood ransom is due if the fetus
is delivered alive and then dies immediately after delivery, and ghorra ( 1/20
of the diyah) if delivered dead.” (Shaltout Islam: creed & Law) (55).
Imam
Ghazali (died 505 H = 1122 AD) in his well-known book Ihyia Oloom addin
considered abortion at all stages of conception to be Haram, with a gradation
of the sin along with the advent of pregnancy.
It is tantamount to manslaughter if he is delivered alive and then dies
because of the abortificient act or drug.
However, he recognized that the abortion of Nutfa (at 40 days) is much
less of a crime than the abortion of Alakah (40 to 80 days), which is less than
the abortion of Modgha (80 to 120 days).
It becomes a full crime after ensoulment i.e. after 120 days. In his opinion, abortion should be avoided
at all stages of pregnancy except if the life of the expectant mother is
endangered (25,41,54).
Muslim
physicians like Abubaker Al Rhazi (died 313 H/925 AD) mentioned in his book Al
Mansouri and in his encyclopedic Al Hawi many abortificient drugs and methods
to be used if continuation of pregnancy is going to endanger the health or life
of the expectant mother. Similarly Ibn
Sina (Avicinna) wrote in his well known (Al Kanoon fi Tibb) a chapter on medical
indications of abortion and how to perform it (25).
I
think that their recognition of the need of abortion in certain cases where
continuation of pregnancy is going to endanger the health or life of the
expectant mother, is more realistic and humane than the stance of the church in
medieval Europe, and the Catholic church up to this moment.
Abortion
on demand, as carried out in many countries, which liberalized abortion laws,
will never be condoned by Shariah (Islamic Law). Unfortunately Tunisia passed a law 65/24 dated 1st
July 1965, which allowed abortion for tenous reasons. It became worse when the law no. 73-75 dated 19th
November 1973 came into effect. It
allowed abortion on demand in the first trimester of pregnancy, and on tenous
reasons in the second half of pregnancy (25).
It
is the only Muslim country with such a law defying all the recognized Fatwas
from all Islamic Jurists and Islamic jurists conferences and meetings. Turkey allows abortion with some
restrictions i.e. there should be some medical or social reason. The rest of the Islamic countries will allow
abortion either to safeguard the expectant mother from serious squeals of
pregnancy endangering her health or her life.
Many have recognized abortion for a seriously malformed embryo or
fetus. The time limit for carrying such
abortions is 120 days computed from fertilization which is equivalent to 134
days from the LMP (25,41).
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18 Tifts: Curse Heaven for little girl